Imaging the effects of androgen deprivation therapy on cognitive functions in pat

描述(申请人提供)：前列腺癌是美国男性最常见的癌症(非黑色素性皮肤癌除外)。许多前列腺癌患者将接受多年的雄激素剥夺治疗(ADT)。过去已经描述了ADT的多种副作用和风险，包括一系列身体症状、性欲丧失和阳萎。然而，ADT对认知功能的影响仍不清楚，认知功能是生活质量的主要决定因素。认知能力的改变已有报道，但之前仅使用神经心理学测试的研究结果一直不明确。我们假设ADT导致认知功能受损，而神经心理学测试并不能充分认识到这一点，因为许多这些测试是为了检测相对严重的认知功能下降，如阿尔茨海默氏症或创伤性脑损伤后。这项先导性研究建议将脑功能成像与一项检查关键额叶执行功能的行为任务相结合，以评估ADT对认知的影响。无明显转移的前列腺癌患者ADT治疗前后的脑功能成像结果将与传统的神经认知测试和生活质量问卷结果相关联。年龄匹配、从未接受过ADT治疗的前列腺癌患者将被纳入对照组。这项拟议的研究旨在获得关键数据，为进一步检查激素治疗对认知的影响及其潜在的可预防性或可逆性的更大规模的研究做准备。了解ADT导致的潜在认知损害的神经基础有助于识别风险最高的个体，并导致新的策略，将与ADT相关的认知变化降至最低。这将提高对未来前列腺癌患者的护理质量。此外，这项研究的结果可以强调功能磁共振脑成像的用途，以评估其他药物治疗癌症对认知的影响。 公共卫生相关性：叙述许多患有前列腺癌的男性会受到激素治疗副作用的影响。前列腺癌激素治疗对认知功能的影响尚不清楚，认知功能是生活质量的主要决定因素。这项研究建议使用脑成像来直接测量激素治疗对前列腺癌患者开始激素治疗前后认知的影响。[大脑成像的结果将与神经认知测试和生活质量问卷获得的分数相关联。]

DESCRIPTION (provided by applicant): Abstract/Summary Prostate cancer is the most frequently diagnosed cancer in US men (except for non-melanomatous skin cancer). Many patients with prostate cancer will undergo years of androgen deprivation therapy (ADT). A multitude of side effects and risks of ADT have been described in the past and include a range of constitutional symptoms, loss of libido and impotence. However, the impact of ADT on cognitive functions, a major determinant of quality of life, remains unclear. Changes in cognitive performance have been reported but results of previous studies using neuropsychological tests alone have been equivocal. We hypothesize that ADT leads to impaired cognitive function that are not sufficiently recognized by neuropsychological testing as many of these test were developed to detect relatively severe cognitive decline, such as in Alzheimer's Dementia or after traumatic brain injury. This pilot study proposes to use functional brain imaging in combination with a behavioral task that examines critical frontal executive function to evaluate the effects of ADT on cognition. The results of functional brain imaging before and after initiation of ADT in prostate cancer patients without overt metastatic disease will be correlated to results of traditional neurocognitive tests and quality-of-life questionnaires. Age-matched subjects with prostate cancer who have never been treated with ADT will be enrolled to the control arm. The proposed study aims to obtain critical data in preparation for larger scale studies that further examine the effects of hormonal treatments on cognition and their potential preventability or reversibility. Understanding the neural basis of potential cognitive impairment as a result of ADT can help to identify individuals at highest risk and lead to new strategies to minimize cognitive changes related to ADT. This would result in improved quality of care for future prostate cancer patients. Furthermore, results of this study could underscore the utility of functional magnetic brain imaging to assess the impact on cognition of other pharmacological cancer treatments. PUBLIC HEALTH RELEVANCE: Narrative Many men with prostate cancer will be affected by side effects of hormonal therapy. The impact of hormonal therapy for prostate cancer on cognitive function, a major determinant of quality of life, remains unclear. This study proposes to use brain imaging to directly measure the effects of hormonal therapy on cognition in patients with prostate cancer before and after initiation of hormonal therapy. [The results of brain imaging will be correlated with scores obtained by neurocognitive testing and quality-of-life-questionnaires.]